A case of hypopituitarism due to granulomatous and lymphocytic adenohypophysitis with minimal pituitary enlargement: a possible variant of lymphocytic adenohypophysitis

Abstract

A 47-year-old woman complaining of cold intolerance, general weakness and amenorrhea of 10 months duration was diagnosed, by endocrine examinations, as having panhypopituitarism. Skull x-ray films revealed a slightly enlarged sella with double floor sign and MRI showed a low intensity mass in the pituitary. Transsphenoidal exploration disclosed a degenerated pituitary gland, the histology of which showed a granulomatous lesion with moderate lymphocytic infiltration but containing no multinuclear giant cells. No caseous necrosis, causative microorganisms, or BCG antigen were noted. The present case is considered a variant form of lymphocytic adenohypophysitis.